Four main categories of health insurance plans are available to people in the US. All these health insurance plans provide managed networks of health care for US citizens. These four categories include PPOs (Preferred Provider Organizations), POSs (Point of Service plans), HMOs (Health Maintenance Organization plans), and Indemnity or Fee-for-Service plans.
Preferred Provider Organization Plans - Under these plans what you obtain is lower fee structure in respect of obtaining treatment from plan listed doctors, other health providers, clinics, and hospitals. Of course you can obtain treatment from doctors or hospitals that are not covered under the plan but then the fee structure is more than what it is under a PPO plan.
For example your PPO may reimburse to you about 90% of your incurred costs towards treatment from an approved health care provider or institution. On the other hand, if you get the same treatment from a non-approved health care provider, you may receive only about 70% of the treatment cost towards reimbursement under the plan.
Point of Service plans - This plan provides maximum flexibility to you as to the health provider from whom you get your treatment from. You may go to a PPO provider, an HMO approved primary care physician, or to a rank outsider. Therefore under a POS plan you get to control your health.
Health Maintenance Organization plans - Under these, what you do is to pay in advance for your coverage, rather than do so separately for each different health related service. It is a plan which boils down to a monthly premium in lieu of which you receive lumped health services inclusive of preventative care, vision care, and dental care.
Under such a plan you meet a primary health care provider who then refers you to one of several listed secondary health care providers. So, under the HMO plan, the primary health care provider acts as a coordinator of health care services for you. A co-payment is a usual feature of the majority of HMO plans in practice. As part of this feature, you need to make a payment from your pocket for certain specialized health care services obtained by you during hospital stay or visit.
Fee for service plan - This plan is also known as an Indemnity plan. Under the plan the insurance company reimburses health care providers for each separate service received from them on a case by case basis. The health care provider needs to lodge an insurance claim to the insurance provider after which the insurer reimburses the money spent by the health care provider on you. A feature of the Fee-for-Service plan is that you need to pay a sum of money as deductible on an annual basis. The plan gives you freedom to obtain treatment from hospitals, doctors, or clinics of your own choice.
Preferred Provider Organization Plans - Under these plans what you obtain is lower fee structure in respect of obtaining treatment from plan listed doctors, other health providers, clinics, and hospitals. Of course you can obtain treatment from doctors or hospitals that are not covered under the plan but then the fee structure is more than what it is under a PPO plan.
For example your PPO may reimburse to you about 90% of your incurred costs towards treatment from an approved health care provider or institution. On the other hand, if you get the same treatment from a non-approved health care provider, you may receive only about 70% of the treatment cost towards reimbursement under the plan.
Point of Service plans - This plan provides maximum flexibility to you as to the health provider from whom you get your treatment from. You may go to a PPO provider, an HMO approved primary care physician, or to a rank outsider. Therefore under a POS plan you get to control your health.
Health Maintenance Organization plans - Under these, what you do is to pay in advance for your coverage, rather than do so separately for each different health related service. It is a plan which boils down to a monthly premium in lieu of which you receive lumped health services inclusive of preventative care, vision care, and dental care.
Under such a plan you meet a primary health care provider who then refers you to one of several listed secondary health care providers. So, under the HMO plan, the primary health care provider acts as a coordinator of health care services for you. A co-payment is a usual feature of the majority of HMO plans in practice. As part of this feature, you need to make a payment from your pocket for certain specialized health care services obtained by you during hospital stay or visit.
Fee for service plan - This plan is also known as an Indemnity plan. Under the plan the insurance company reimburses health care providers for each separate service received from them on a case by case basis. The health care provider needs to lodge an insurance claim to the insurance provider after which the insurer reimburses the money spent by the health care provider on you. A feature of the Fee-for-Service plan is that you need to pay a sum of money as deductible on an annual basis. The plan gives you freedom to obtain treatment from hospitals, doctors, or clinics of your own choice.